The coronavirus mutation that threatens the race to develop vaccine South China Morning Post
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The coronavirus mutation that threatens the race to develop vaccine - South China Morning Post
Coronaviruses have been causing problems for humanity for a long time. Several versions are known to trigger common colds and more recently two types have set off outbreaks of deadly illnesses: severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers).
But their impact has been mild compared with the global havoc unleashed by the coronavirus that is causing the Covid-19 pandemic. In only a few months it has triggered lockdowns in dozens of nations and claimed more than 100,000 lives. And the disease continues to spread.
That is an extraordinary achievement for a spiky ball of genetic material coated in fatty chemicals called lipids, and which measures 80 billionths of a metre in diameter. Humanity has been brought low by a very humble assailant.
On the other hand, our knowledge about the Sars-CoV-2, the virus that causes Covid-19, is also remarkable. This was an organism unknown to science five months ago. Today it is the subject of study on an unprecedented scale. Vaccines projects proliferate, antiviral drug trials have been launched and new diagnostic tests are appearing.
The questions are therefore straightforward: what have we learned over the past five months and how might that knowledge put an end to this pandemic?
The Sars-CoV-2 virus almost certainly originated in bats, which have evolved fierce immune responses to viruses, researchers have discovered. These defences drive viruses to replicate faster so that they can get past bats immune defences. In turn, that transforms the bat into a reservoir of rapidly reproducing and highly transmissible viruses. Then when these bat viruses move into other mammals, creatures that lack a fast-response immune system, the viruses quickly spread into their new hosts. Most evidence suggests that Sars-CoV-2 started infecting humans via an intermediary species, such as pangolins.
This virus probably jumped from a bat into another animal, and that other animal was probably near a human, maybe in a market, says virologist Professor Edward Holmes of Sydney University. And so if that wildlife animal has a virus its picked up from a bat and were interacting with it, theres a good chance that the virus will then spread to the person handling the animal. Then that person will go home and spread it to someone else and we have an outbreak.
As to the transmission of Sars-CoV-2, that occurs when droplets of water containing the virus are expelled by an infected person in a cough or sneeze.
Virus-ridden particles are inhaled by others and come into contact with cells lining the throat and larynx. These cells have large numbers of receptors known as Ace-2 receptors on their surfaces. (Cell receptors play a key role in passing chemicals into cells and in triggering signals between cells.) This virus has a surface protein that is primed to lock on that receptor and slip its RNA into the cell, says virologist Professor Jonathan Ball of Nottingham University.
Once inside, that RNA inserts itself into the cells own replication machinery and makes multiple copies of the virus. These burst out of the cell, and the infection spreads. Antibodies generated by the bodys immune system eventually target the virus and in most cases halt its progress.
A Covid-19 infection is generally mild, and that really is the secret of the viruss success, adds Ball. Many people dont even notice they have got an infection and so go around their work, homes and supermarkets infecting others.
By contrast, Sars which is also caused by a coronavirus makes patients much sicker and kills about one in 10 of those infected. In most cases, these patients are hospitalised and that stops them infecting others by cutting the transmission chain. Milder Covid-19 avoids that issue.
Occasionally, however, the virus can cause severe problems. This happens when it moves down the respiratory tract and infects the lungs, which are even richer in cells with Ace-2 receptors. Many of these cells are destroyed, and lungs become congested with bits of broken cell. In these cases, patients will require treatment in intensive care.
Even worse, in some cases, a persons immune system goes into overdrive, attracting cells to the lungs in order to attack the virus, resulting in inflammation. This process can run out of control, more immune cells pour in, and the inflammation gets worse. This is known as a cytokine storm. (In Greek, cyto means cell and kino means movement.) In some cases, this can kill the patient.
Just why cytokine storms occur in some patients but not in the vast majority is unclear. One possibility is that some people have versions of Ace-2 receptors that are slightly more vulnerable to attacks from the coronavirus than are those of most people.
Doctors examining patients recovering from a Covid-19 infection are finding fairly high levels of neutralising antibodies in their blood. These antibodies are made by the immune system, and they coat an invading virus at specific points, blocking its ability to break into cells.
It is clear that immune responses are being mounted against Covid-19 in infected people, says virologist Mike Skinner of Imperial College London. And the antibodies created by that response will provide protection against future infections but we should note that it is unlikely this protection will be for life.
Instead, most virologists believe that immunity against Covid-19 will last only a year or two. That is in line with other coronaviruses that infect humans, says Skinner. That means that even if most people do eventually become exposed to the virus, it is still likely to become endemic which means we would see seasonal peaks of infection of this disease. We will have reached a steady state with regard to Covid-19.
The virus will be with us for some time, in short. But could it change its virulence? Some researchers have suggested that it could become less deadly. Others have argued that it could mutate to become more lethal. Skinner is doubtful. We have got to consider this pandemic from the viruss position, he says. It is spreading round the world very nicely. It is doing OK. Change brings it no benefit.
In the end, it will be the development and roll-out of an effective vaccine that will free us from the threat of Covid-19, Skinner says.
On Friday, the journal Nature reported that 78 vaccine projects had been launched round the globe with a further 37 in development. Among the projects that are under way is a vaccine programme that is now in phase-one trials at Oxford University, two others at US biotechnology corporations and three more at Chinese scientific groups. Many other vaccine developers say they plan to start human testing this year.
This remarkable response raises hopes that a Covid-19 vaccine could be developed in a fairly short time. However, vaccines require large-scale safety and efficacy studies. Thousands of people would receive either the vaccine itself or a placebo to determine if the former were effective at preventing infection from the virus which they would have encountered naturally. That, inevitably, is a lengthy process.
As a result, some scientists have proposed a way to speed up the process by deliberately exposing volunteers to the virus to determine a vaccines efficacy. This approach is not without risks but has the potential to expedite candidate vaccine testing by many months, says Nir Eyal, a professor of bioethics at Rutgers University.
Volunteers would have to be young and healthy, he stresses: Their health would also be closely monitored, and they would have access to intensive care and any available medicines. The result could be a vaccine that would save millions of lives by being ready for use in a much shorter time than one that went through standard phase three trials.
But deliberately infecting people in particular volunteers who would be given a placebo vaccine as part of the trial is controversial. This will have to be thought through very carefully, says Professor Adam Finn of Bristol University. Young people might jump at the opportunity to join such a trial but this is a virus that does kill the odd young person. We dont know why yet. However, phase-three trials are still some way off, so we have time to consider the idea carefully.
This article was amended on 12 April 2020. The original version incorrectly described the Covid-19 virus as measuring an 80-billionth of a metre, when it should have said 80 billionths of a metre. A quote from Mike Skinner, responding to whether Covid-19s virulence could change, was also corrected.
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Five months on, what scientists now know about the coronavirus - The Guardian
A pharmacist gives Jennifer Haller, left, the first shot in the first-stage safety study clinical trial of a potential vaccine for COVID-19, the disease caused by the new coronavirus, Monday, March 16, 2020, at the Kaiser Permanente Washington Health Research Institute in Seattle. (AP Photo/Ted S. Warren)
In the fight against the coronavirus outbreak, numerous drugs are being explored and a vaccine is still ages away. Prominent among the drugs being explored is hydroxychloroquine. Whats the status of the research for its use in treating this virus?
Hydroxychloroquine was invented for the treatment of malaria, and malaria is a parasite. So in order to treat parasites, you need an antiparasitic drug, which is what hydroxychloroquine has. If you want to treat a bacterial infection, you use an antibiotic and the other drug in this COVID cocktail is azithromycin, which is a common antibiotic, said local MD Dr. Gordon Cohen.
But COVID-19 is a virus, and when we want to treat viral infections, we need antivirals. There have been some antiviral drugs that have been tried the first two drugs that were tried were drugs that were used for the treatment of HIV and the results were poor.
Overlake doctor: Do not delay medical care for fear of COVID-19
But Cohen points to Favipiravir, a drug being tested by the Fuji Film corporation in Japan and in the U.S. that looks promising.
This drug has the correct mechanism of action. When you look at how it works at fighting viruses, its actually designed to treat viruses like COVID-19, so it looks very promising, he said.
Is there any chance of getting a vaccine before the 18 months that were told its going to take?
The first human trial for a vaccine was announced just last month by scientists here in Seattle, and theyre actually taking sort of the unusual step of skipping any animal research to test the vaccine for its safety or effectiveness, he said. Theres also some Australian scientists who have been injecting ferrets with two potential vaccines, and its really the first comprehensive pre-clinical trial to move to the animal testing stage. So thats sort of where were at with the vaccine landscape.
Parenting and working from home during coronavirus
We need to keep in mind vaccines may seem like theyre the answer, but are they really the answer? So, first of all, we havent been that effective at developing vaccines against coronaviruses. Coronaviruses are responsible for the common cold. Well, how often do you see people getting a vaccine for the common cold? We dont see that.
Dr. Cohen believes were more likely to find a drug treatment than a vaccine in the near future.
If I had to bet, I think were more likely to get to a drug as a treatment solution earlier than we do as a vaccine. And the benefit to that is we can get a drug to everybody. If you get sick, you get the treatment. Whereas with the vaccine, its going to be hard to suddenly inoculate 350 million Americans overnight and inoculate the rest of the world.
Listen to Seattles Morning News weekday mornings from 5 9 a.m. on KIRO Radio, 97.3 FM. Subscribe to thepodcast here.
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Vaccines versus drug treatments in the fight against coronavirus - MyNorthwest.com
Jonas Salk developed the polio vaccine at a University of Pittsburgh lab. The deadly disease that crippled infants disappeared almost overnight, and Salk became a hero. He wasnt Steel Citys only history-making physician. Thomas Starzl, who performed the first liver transplant in 1963, joined the Pitt faculty in 1981.
As the world faces another terrifying disease, Pitt medical scientists are again at work on a potentially revolutionary vaccine. Louis Falo and Andrea Gambotto, respectively a dermatologist and a surgeon, have developed a Covid-19 inoculation that rapidly produces large numbers of coronavirus antibodies when injected in mice. A peer-reviewed paper describing their work appeared in the journal EBioMedicine, which is published by The Lancet. They await approval from the Food and Drug Administration to conduct human trials on their vaccine candidate, which is delivered via a unique skin patch containing 400 tiny needles.
This is a collision of two stories, Dr. Falo says. Weve been developing the delivery technologies for this for the past several years and working with Dr. Gambotto in trying to use the skin as the ideal target for vaccine delivery. While we were doing that, Dr. Gambotto has been working on SARS and MERS. The two physicians labs are next door to each other.
Both SARS and MERS are caused by coronaviruses. So we had experience in studying both SARS-CoV in 2003 and MERS-CoV in 2014. We knew how to fight this new virus, said Dr. Gambotto. That work, he says, made the development process for the current pandemic virus faster.
Neither physician fits the stereotype of the dry, serious scientist. Both men are gregarious and reflect the personality of the city where they work. Dr. Falo grew up in suburban Greensburg. He earned his bachelors in biochemistry and chemistry at Pitt before heading to Harvard Medical School. The plan was always to return to Pitt, he says with his distinct Western Pennsylvania twang. Most people probably dont realize that Pitt is ranked among the top three or four medical centers in terms of funding from the NIH for research. But what really sets it apart is the collaborative environment. ... Its a big-time medical center with a small-town personality.
A native of Bari, Italy, Dr. Gambotto fell in love with Pittsburgh during what was supposed to be a six-month research rotation. They were a really long six months, because 25 years later Im still here, he says, his southern Italian accent thick and lyrical. He and his wife were married at La Prima Coffee shop in the citys Strip District. Thank God I didnt become a gynecologist, he says. My father was a gynecologist, and everybody in my family was. I stopped the tradition, and now I deliver viruses instead of babies.
Thanks to their previous collaborations on vaccine-platform development, the twin teams of Dr. Falo and Dr. Gambotto were able to generate their new potential vaccine, which they call PittCoVac, in a mere seven days. As they wait for the FDAs green light, Dr. Falo says theyre tackling two issues. One is the clinical testing and regulatory process. The other one is the scalability. So can you make a lot of thesemillions, billionsto distribute across the world?
It helps that the vaccine doesnt require refrigeration. That means that we can actually put these in boxes just like Band-Aids, Dr. Falo says, store them, ship them, distribute them globally, which is really important for underdeveloped countries who dont have the means of keeping vaccines cold the entire time.
The regulatory issue is out of their hands. Dr. Falo says the FDA is working as fast as it can while maintaining safety. Weve started that process. Were exchanging data with them, describing what we have, how we make the vaccine, and their experts are evaluating that data to determine whether this vaccine is safe to put into patients.
The University of Pittsburgh is still better known for its football team than for its scientists. But that could change if this vaccine candidate succeeds and beats back the coronavirus. If things go as planned, the names Falo and Gambotto could be as well-known as Jonas Salk.
Ms. Zito is a reporter for the Washington Examiner, a columnist for the New York Post, and a co-author of The Great Revolt: Inside the Populist Coalition Reshaping American Politics.
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They Developed Their Coronavirus Vaccine in Salks Shadow - The Wall Street Journal
As the coronavirus continues to spread throughout the U.S., Axios is answering readers' questions about the pandemic how it spreads, who's at risk, and what you can do to stay safe.
What's new: This week, we answer questions on exercising outside, safely doing laundry, soaps and disinfectants, and the pneumonia vaccine.
Q: Should I go outside to exercise during the outbreak?
Q: How can I make sure I'm safely doing laundry at home or in my apartment building's laundry room?
Q: What counts as soap? Can I use dish detergent or body wash?
Q: Can I make hand sanitizer at home?
Q: Could the pneumonia vaccine offer some kind of protection against COVID-19?
Go deeper: We're still in the early days of coronavirus vaccine research
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Coronavirus Q&A: exercise, laundry, what counts as soap, and vaccines - Axios
Editor's Note: The world is reeling from the COVID-19 crisis and the vulnerable segments of our society are the most at risk. Microsoft News India is supporting HelpAge India buy hygiene kits for the elderly. You can help the charity reach many more.Donate herefor the cause (you will be directed to the HelpAge India site).
A vaccine for COVID-19 could be ready as soon as September, according to a professor from Oxford University. Sarah Gilbert is a professor of vaccinology and says that she is "80% confident" a COVID-19 vaccine being developed by her team will work.
Other Human trials will start within the next fortnightHer team at Oxford is part of a global effort to find a vaccine for coronavirus which has killed more than 100,000 people around the world, according to Johns Hopkins University..
Professor Gilbert has said that human trials are set to take place within the next fortnight, and that she has been working seven days a week to get a vaccine rushed through.
Other Professor Sarah Gilbert believes a vaccine could be ready by September. Pic: University of OxfordShe told The Times newspaper: "I think there's a high chance that it will work based on other things that we have done with this type of vaccine.
"It's not just a hunch and as every week goes by we have more data to look at. I would go for 80%, that's my personal view."
She added that having something ready by the autumn is "just about possible if everything goes perfectly", but warned that "nobody can promise it's going to work".
The lockdown in the UK could make it more difficult to test the vaccine, as human contact is low, so researchers will have to conduct trials somewhere with a higher rate of transmission, to get a quicker result.
In pictures: Coronavirus outbreak (Photos)
Earlier in the week, researchers at Southampton University said they had discovered that the virus has "low shielding", meaning a vaccine could be easier to develop.
The UK is at the forefront of vaccine funding, and pumped 210m into an international fund last month - the biggest contribution at the time for a vaccine.
The government has also said that it would be willing to buy millions of doses, should trials prove successful.
However, despite the optimism from Oxford, other vaccine developers have said it could be up to a year before something is ready to distribute.
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Ministers have been under pressure to explain details of the government's exit-strategy from the ongoing lockdown, but scientists say that it is too early to consider removing the widespread restrictions while the number of dead still rises.
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See what it takes to make a vaccine during the coronavirus pandemic | TheHill - The Hill
LISBON (Reuters) - An American mother-of-three is a long-time member of anti-vaxxer groups online: a small but vocal global community that believes vaccines are a dangerous con and refuse to immunize themselves or their children.
FILE PHOTO: Demonstrators, including anti-vaccine protestors, stand outside of the U.S. Grant Hotel following U.S. President Donald Trump's arrival in San Diego, California, U.S., September 18, 2019. REUTERS/Tom Brenner/File Photo
But COVID-19 is shaking her views. The woman who would identify herself only as Stephanie, citing a fear of reprisals from committed anti-vaxxers, says she is now 50:50 on taking a vaccine should one be discovered for the respiratory disease caused by the new coronavirus.
Ive definitely thought about it, she told Reuters by phone from the United States, also expressing frustration at what she considers the anti-vax communitys downplaying of the pandemics seriousness. Were all being affected by this virus, schools closing, young people in hospital, and they still say its a hoax.
As the worlds scientists and pharmaceutical companies seek a cure for the coronavirus, other anti-vaxxers are gearing up for a fight against any potential new vaccine.
Refuse, demonstrate, said a Briton on Facebook in response to a post asking people how they would react if a vaccine was made mandatory.
But some virologists say the quest for a vaccine is so widely supported that resistance will be eroded.
The latest national surveys by pollster ORB International for the Vaccine Confidence Project (VCP), which monitors attitudes to immunisation, appear to support this idea.
In France, where a 2018 poll showed one in three people did not view vaccines as safe, just 18% would refuse a coronavirus vaccine now, according to the VCP poll of around 1,000 people on March 18, a day after France locked down.
In Australia, the VCPs figure was also 7%, while Britain, where about 2,000 people were polled, and Austria registered 5% opposition in polls there a week later.
If a vaccine were made available tomorrow, everyone would jump to get it, said Laurent-Henri Vignaud, who co-authored a history of Frances anti-vax movement.
That view was challenged by Mary Holland, vice-chair of American non-profit group Childrens Health Defense, which is critical of vaccination in the United States.
I dont think this virus fundamentally changes peoples deeply held concerns about vaccines, she told Reuters.
Although the term anti-vax is sometimes associated with conspiracy theories, many people are simply concerned about side-effects or industry ethics.
Globally, one person in five does not view vaccines as safe or is unsure, according to a 2018 survey by the Wellcome Trust health fund. reut.rs/2JTb27q
In China, where the COVID-19 disease caused by the novel coronavirus originated, surveys by VCP researchers show safety is an important cause of concern. Several scandals eroded trust, including in 2018 when a unit of Chinas vaccine maker Changsheng Bio-technology Co Ltd was heavily fined for falsifying data for a rabies vaccine. The company said it was deeply sorry for the incident.
Online discussions tracked by Reuters - including closed Facebook pages with more than 200,000 members, Twitter feeds such as the Childrens Health Defense and YouTube videos totalling over 700,000 views - showed considerable mistrust that a rushed vaccine would be improperly tested.
VCP director Heidi Larson said that was also the main reason for concern around the vaccine against the H1N1 swine flu pandemic in 2009.
A quickly produced swine flu vaccine in 1976 led to about one in 100,000 people developing Guillain-Barre syndrome, a paralyzing immune-system disorder, according to the Center for Disease Control and Prevention (CDC).
Some 115 coronavirus vaccine candidates are being developed by institutes and drugmakers, according to the Coalition for Epidemic Preparedness Innovation, a global alliance financing and coordinating the development of vaccines.
I will not be injected with anything, especially a fast-tracked vaccine, added American Vicki Barneck, 67, who believes a strong immune system is enough to combat the disease.
Holland, of the Childrens Health Defense, said: Some react fine to vaccines, others are paralysed or killed.
However, a 2015 paper by CDC epidemiologists said multiple studies and scientific reviews have found no association between vaccination and deaths except in rare cases.
The VCP is running an 18-month study tracking conversation online about the coronavirus and conducting global polls to measure attitudes towards social distancing, isolation, hand-washing and anticipating a vaccine.
From analysing more than 3 million posts a day between January and mid-March 2020, director Dr Heidi Larson said the vast majority were eager for a treatment, fast.
People are hungry for a vaccine, she said.
In Italy, which has been hit badly by COVID-19, the anti-vax movement has virtually disappeared in the discussion on the coronavirus, according to virologist Dr Roberto Burioni.
For a coronavirus vaccine to be effective, wide uptake and annual vaccination is likely to be required, said George Kassianos, immunisation lead at the Royal College of General Practitioners in London.
There is also the question of how to distribute fast enough to people lining up for the vaccine.
Essential workers will be the priority. Police officers, hospital workers, cleaners. Then at-risk groups, said Douglas L. Hatch, a physician specialised in pandemic preparedness working on the COVID-19 response in San Francisco.
By the time you get to the anti-vaxxers, theyll have trouble getting it even if they wanted to.
(Corrects French poll data in eighth paragraph)
Reporting by Victoria Waldersee; Editing by Andrei Khalip, Andrew Cawthorne and Timothy Heritage
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Im confused by all these new words
Seldom have we had to get to grips so quickly with a slew of new terms and abbreviations. Had you told most people last Christmas that soon they would be WFH, they might have considered it a cryptic insult. Most probably had only a vague idea what an epidemiologist did or what a ventilator was, while PPE was (if anything) a soft Oxford degree favoured by politicians, rather than the personal protective equipment now urgently needed in hospitals. Few could have told you the difference between an epidemic (the outbreak and rapid spread of an infectious disease through a population) and a pandemic (an epidemic that occurs over a very wide geographical area, perhaps the whole world).
Even the terminology of the virus itself is challenging: the coronaviruses are a family of pathogens, this particular one (being related to that which caused the Sars outbreak of 2002-3) denoted Sars-CoV-2. Covid-19 is the respiratory syndrome it causes, much as Aids is to HIV. A vaccine confers immunity (probably just for a limited period) to the virus; an antiviral interferes with viral replication in the body to slow or arrest its bad effects. Antibiotics attack bacterial pathogens, not viruses, but may be needed with Covid-19 to treat secondary infections such as pneumonia that take advantage of a compromised immune system. Expect to hear lots in the coming weeks about serological tests, which look for proteins in the blood that signal past infection, even if the virus has long since been cleared from the body. Those tests are under development, and they will provide vital information on how widespread infection has been and whether many (or few) have had Covid-19 without any symptoms at all.
While comparisons with wartime and the blitz spirit are deeply misleading, one analogy holds: the second world war slogan Loose talk can cost lives is apt here too.
What makes the coronavirus so deadly is a combination of two numbers. The reproduction number (denoted R0) is the average number of people an infected individual goes on to infect in the absence of any social distancing or quarantining; the mortality rate is the percentage of infected people who die.
Both depend on the biology of the virus, but neither is fixed. R0 for the coronavirus is about 2.5 to three (compared with 1.3 for common flu), but thats an average it varies from person to person. Reducing person-to-person contacts cuts the effective reproduction number R and the epidemic will decay if it drops below one. The mortality rate, meanwhile, depends on the availability of healthcare for people with the most serious symptoms: it is about 0.4% in Germany, 4.6% in the UK, and more than 10% in Iran.
Symptoms are defined by the NHS as either:
NHS advice is that anyone with symptoms shouldstay at home for at least 7 days.
If you live with other people,they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start.Even if it means they're at home for longer than 14 days.
If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.
If you have to stay at home together, try to keep away from each other as much as possible.
After 7 days, if you no longer have a high temperature you can return to your normal routine.
If you still have a high temperature, stay at home until your temperature returns to normal.
If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.
Staying at home means you should:
You can use your garden, if you have one. You can also leave the house to exercise but stay at least 2 metres away from other people.
If you have symptoms of coronavirus, use theNHS 111 coronavirus serviceto find out what to do.
Source:NHS Englandon 23 March 2020
The bad news is that low testing rates means it is virtually impossible to track the progress of the virus, and can give a false sense of security. The good news is that if more people have the virus than we know, the mortality rate will be lower than the official value. There have been speculations that the extent of infection might be much greater than thought, and that most cases dont even show symptoms. But this idea is hard to reconcile with observations from countries with extensive testing, which seem to indicate that few people get the virus without knowing.
When you see a WhatsApp message about A friend who is an A&E doctor at a leading hospital , dont assume it is reliable, even if it came from your own friend. Dont, even with the best of intentions, tell your other friends about it.
If you want to check the credibility of social media posts, organisations such as FullFact and Snopes audit messages doing the rounds.
Remember also the old quip that the plural of anecdote is not data. We notice anomalies and give them undue emphasis. Some highly unusual cases, among so many infections, are to be expected but this doesnt mean they are true or examples of a common phenomenon.
The news website The Conversation has a handy guide to spotting fake news. Perhaps the most useful of its tips is: If the story appears to claim a much higher level of certainty in its advice and arguments than other stories, this is questionable.
Sorting fact from fiction has become harder in this crisis because even well informed experts arent always united in their advice. Disagreements are normal in science, but are rarely a matter of life and death. It has been as frustrating and unsettling to science reporters as it has to everyone else to find experts at loggerheads over basic concepts such as herd immunity. It is, frankly, still a source of puzzlement why it took a single modelling study from Imperial College London to persuade expert government scientific advisers of what other experts (such as those at the World Health Organization) had been saying all along: that without stringent containment measures, the UK death rate would be catastrophic.
So now even the fine details of the science are being held up to us all for scrutiny. Its unprecedented for a national newspaper to publish a full, simplified version of a scientific paper, as the Observer did with the Imperial study. There will need to be more of this and with luck, it will spread understanding of how scientific results are carefully formulated and circumscribed with caveats, so that experts are seen as well-informed specialists doing their best with the tools and data at hand.
With the stakes this high, experts exploring speculative ideas take on a responsibility they arent used to. A study from epidemiologists at Oxford recently caused a stir when it was reported as claiming that as much as half of the UK population might have already been infected with the coronavirus, mostly without any symptoms. The work was quite reasonably exploring a what if scenario. But the headline in the Financial Times made it sound like an empirical possibility. Researchers will need to be more explicit about what their findings do and do not mean.
All drugs have to pass stringent tests before they are approved for use. In general they are first tested on animals, and then enter clinical trials on humans, of which there are three stages. Phase one, conducted on small numbers of healthy volunteers, checks for safety, looking for toxicity or serious side-effects. Phase two then tests whether the drug actually works in humans with the condition targeted. Finally, phase three trials are conducted on large numbers of people typically hundreds or thousands to see how it will work in the clinic and make sure there are no other complications or failures before making the drug generally available.
Vaccines will have to go through all of these phases, and could, like most candidate drugs, fail at any one of them. While drug-regulation agencies are considering ways to streamline and fast-track the process because of the urgency of the situation, this can only go so far. A coronavirus vaccine would be given to millions of healthy people ultimately, perhaps to most of the worlds population and so its more essential than ever that its safety is checked thoroughly.
Whats more, even when a vaccine gets approved, manufacturing it at such a large scale will be a tremendous challenge only a few pharmaceutical companies worldwide have that capacity. And distribution will present difficulties too, especially to more remote parts of developing countries, or among overcrowded, poorer neighbourhoods in large megacities. If, as is hoped, a vaccine is ready by the middle of 2021, that speed will be remarkable and unprecedented.
It is hoped that some antivirals already developed and tested for other conditions, such as Ebola (remdesivir) or Sars, could work for Covid-19, because they attack similar targets in the virus. In that case some of the testing has essentially already been done, so we would get a head start. There is also broader interest in drug repurposing investigating whether the many drugs that failed for their intended use, but which passed the safety trials, could prove effective for quite different conditions.
In tests on a new drug how safe or effective it is it matters how big the sample is. Drugs dont get approved until they have been tested on hundreds or thousands of people, so outcomes for just a dozen or so are highly preliminary and far from proving efficacy.
Be especially cautious of reports that rely heavily on quotes from drug companies. They are very unlikely to be lying, but institutional press offices have become accustomed to putting a rosy spin on their researchers work and drug companies are under commercial pressures that dont always encourage them to give the full picture. You neednt be cynical, just cautious.
Whether Twitter is a handy, up-to-the-minute source of information, or a hive of misinformation and conspiracy theories, is largely up to you. All the usual caveats about using Twitter beware of strong opinions from pseudonymous tweeters with 15 followers, or of hot takes from media loudmouths with no expertise are multiplied and compounded here. For the problem with the subject of coronavirus on Twitter is that its not just the trolls and attention-seekers who are weighing in. Plenty of serious academics, too, have taken it upon themselves to become epidemiologists and virologists overnight, criticising or praising scientific studies or government policies with all the assurance of seasoned veterans. Often what they say is not ignorant or wild, but merely narrow and lacking context they might be good at interpreting statistics, say, while having no knowledge of viral transmission or mass behaviour. Fear seems to be causing the usual academic caution to be replaced by hubris.
As the site itself says, Anyone can publish on Medium but we dont fact-check every story. Make that your starting point for anything you read there.
This doesnt mean its wrong. But the authoritative-looking stuff you might encounter is probably not coming from experts. One post that went viral, Coronavirus: The Hammer and the Dance, which used an array of charts and statistics to argue for strong containment measures to avoid massive fatalities, was by Tomas Pueyo, a Silicon Valley consultant who works on educational online content and has no epidemiological training. His post was promoted by a content marketing firm and was shared by the likes of Margaret Atwood and Steven Pinker. Whether or not it was accurate in all its details, it sent out a needed wake-up call about the dangers. But other unqualified corona influencers have spread dangerous messages, for example about hoaxes and bogus treatments. Medium has now announced that it will give careful scrutiny to coronavirus-related content to help stem misinformation that could be detrimental to public safety, and will remove any that it deems harmful.
First ask: does this theory confirm the suspicion Ive had all along? About, for instance, 5G? Because if so, double your scepticism and then double it again. We arent so much duped as flattered into buying these theories, and the first defence against confirmation bias is to recognise that no one has natural immunity to it.
The harder ones to avoid are political, because they both speak more directly to our prejudices and are tougher to disprove. Is it obvious that, say, the government is just trying to keep its big-business donors happy at the expense of our own safety? Wed do well to assume in the first instance that leaders and policymakers are not Machiavellian strategists but error-prone muddlers like the rest of us.
Sorting fact from fiction is made harder by the media habits acquired during Brexit the tendency of broadcast journalists and other media reporters to tweet unattributed and unconfirmed rumours. This grave global crisis should prompt some journalists to take a hard look at the ways they have become accustomed to working.
The rest is here:
The cure for fake news: how to read about the coronavirus - The Guardian
Were all dealing with a new normal right now, and according to the White Houses infectious disease expert, Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, the novel coronavirus pandemic will continue to impact our lives on some level for the foreseeable future.
If you want to get to pre-coronavirus, that might never happen in the sense of the fact that the threat is there, Dr. Fauci said in a press conference on Monday, per CNBC. But... I feel confident that over a period of time, we will get a good vaccine, we will never have to get back to where we are right now.
Even then, though, Dr. Fauci said its unlikely that life will ever be 100% the same. When we say getting back to normal, we mean something very different from what were going through right now, because right now we are in a very intense mitigation, Dr. Fauci said. If back to normal means acting like there never was a coronavirus problem, I dont think thats going to happen until we do have a situation where you can completely protect the population [with a vaccine].
Without a vaccine, the risk of contracting COVID-19 will still be there, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. A vaccine is the only way we can control this virus for the long term, he says. It is not going to disappear until we get a vaccine.
A vaccine is the only way we can control this virus for the long term.
A vaccine is especially important for people who will have a harder time fighting off the virus, says Richard Watkins, M.D., infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University. It is needed to prevent illness in everyone, but especially for those with a high risk of complications, such as the elderly or people with a compromised immune system, he says.
Its also unclear at this time how long someone is protected against the novel coronavirus after they get sick and recover. Once you get measles, youre protected for life, but thats not true of all infections, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. You can get whooping cough more than once, and, if you get a cold caused by a coronavirus, you are protected against that strain for about a year. Then, the protection starts to wane.
If COVID-19 behaves like the common cold, even people who have already experienced the virus will be need to be vaccinated in the future, Dr. Schaffner says.
Vaccines can only go to market after theyre approved by the Food and Drug Administration (FDA) and the process generally takes one to two years, sometimes longer, Dr. Watkins says.
First, a company or organization has to create a vaccine that they think is viable. In this case, a COVID-19 vaccine would be developed in cells in a lab, Dr. Schaffner says. If lab tests show that a vaccine has potential, it can move on to animal studies, the FDA says. If the vaccine appears to be safe in animals and studies suggest it will be safe for humans, it can be tested in clinical trials with people.
Clinical trials typically have three phases, with each phase using more people, the FDA explains. In the final phase, vaccinated people are compared with people who have received a placebo or another vaccine so researchers can learn more about the test vaccines safety and effectiveness, and to help identify common side effects. The trials also must prove that a vaccines benefits outweigh any potential risks.
Once all of that has been completed, vaccines are licensed and monitored closely as people begin using them.
Its not entirely clear. Dr. Fauci has said he expects that a vaccine will be ready anywhere from 12 to 18 months from now. That is a very, very rapid timeline, Dr. Schaffner says. But, he adds, the government has the ability to speed things up in situations like this.
Plus, several organizations are already making progress. Pharmaceutical company Inovio announced earlier this week that it has initiated phase one of the clinical trial of its COVID-19 vaccine, and said that the company is hoping to have something that can be used by the public in 12 to 18 months. The National Institutes of Health has also collaborated with Moderna Inc., and administered the first shot in a vaccine trial earlier this month.
Researchers at Johns Hopkins University are also working on a vaccine right now, the school announced, and University of Pittsburgh scientists say their vaccinea microneedle patch that goes on like a Band-Aidhas been successful in creating antibodies against the novel coronavirus within two weeks of application. Its actually pretty painlessit feels kind of like Velcro, said Louis Falo, M.D., Ph.D., one of the vaccines researchers.
Not necessarily. If we flatten the curve and this first surge begins to diminish, and if there is a contributing seasonal component to this vaccine, Im sure the national government and state governors will want to loosen up our stay-at-home orders, Dr. Schaffner says. Obviously, the country has to start getting back to work. It will be a judgment call that will happen in the next few months.
However, Dr. Watkins adds, the virus makes the timeline.
As of now, plenty of groups are racing to try to be the first to get FDA licensing for their vaccine. Scientists are all using slightly different methods, Dr. Schaffner says. Were not putting all of our vaccine eggs in one basket.
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How Long Will It Be Until We Have a Coronavirus Vaccine? Heres What Experts Think - Prevention.com
